金水宝联合血管紧张素受体阻滞剂治疗糖尿病肾病的Meta分析.pdfVIP

• 78 • Drug Evaluation Research 第 38 卷 第 1 期 2015 年 2 月 金水宝联合血管紧张素受体阻滞剂治疗糖尿病肾病的 Meta 分析 段 蓉，李正翔* 天津医科大学总医院，天津 300052 摘 要：目的 用循证医学的方法评价金水宝联合血管紧张素受体阻滞剂（ARB ）治疗糖尿病肾病（DN ）的疗效。方法 检 索国内外科技期刊数据库，纳入金水宝联合 ARB 治疗 DN 的随机对照试验，并进行Meta 分析。结果 共纳入 15 项研究 1 095 例患者，联合用药组可显著降低糖尿病肾病患者的 24 h 尿蛋白定量[P＜0.000 01 ；MD ＝−0.10 （−0.14，−0.06 ）g/24 h]，血 肌酐[P ＝0.000 8 ；MD ＝−16.25 （−25.76 ，−6.73 ）μmol/L] ，尿素氮[P ＝0.000 2 ；MD ＝−1.20 （−1.83，−0.57 ）mmol/L] ，尿白 蛋白排泄率[P ＝0.000 5 ；MD ＝−19.33 （−30.30，−8.37）μg/L]，N-乙酰-β-D-葡萄糖苷酶（NAG 酶）[P＜0.000 01 ；MD ＝−4.92 （−6.03，−3.80 ）U/L] ，尿白蛋白/肌酐[P＜0.000 01 ；MD ＝−21.56 （−26.84 ，−16.29）mg/g] 。表明联合用药可显著降低患者 总胆固醇[P ＝0.000 5 ；MD ＝−0.58 （−0.91，−0.25 ）mmol/L] ，三酰甘油[P＜0.000 01 ；MD ＝−0.40 （−0.51，−0.28 ）mmol/L] 。 结论 金水宝联合 ARB 较单用 ARB 可进一步改善 DN 患者的肾功能，并有降血脂的作用。 关键词：金水宝；血管紧张素受体阻滞剂；糖尿病肾病；Meta 分析；循证医学 中图分类号：R969.4 文献标志码：A 文章编号：1674 - 6376 (2015) 01 - 0078 - 07 DOI: 10.7501/j.issn.1674-6376.2015.01.016 Combined Jinshuibao and angiotensin receptor blocker in treatment of diabetic nephropathy: A Meta-analysis DUAN Rong, LI Zheng-xiang Tianjin Medical University General Hospital, Tianjin 300052, China Abstract: Objective To assess the effect of combined Jinshuibao (JSB) and angiotensin receptor blocker (ARB) on diabetic nephropathy (DN) by method of evidence based medicine. Methods Randomized controlled trials assessing the combined JSB and ARB therapy for DN were retrieved from the domestic and foreign periodicals of science and technology database, and included in this Meta-analysis. Results Fifteen RCT involving 1 095 patients were identified. The effect of combined JSB and ARB was better than that of ARB alone on the 24 h proteinuria [P 0.000 01; MD = −0.10 (−0.14, −0.06) g/24 h], serum creatinine [P = 0.000 8; MD = −16.25 (−25.76, −6.73) μmol/L], urea nitrogen [P = 0.000 2; MD =−1.20 (−1.83, −0.57) mmol/L], urinary